Knee Prosthesis

ABSTRACT

The invention relates to a knee prosthesis with a tibial part ( 1 ) that has concave or plane condylar bearing surfaces ( 2, 3 ). According to the invention, the lateral condylar bearing surface ( 2 ) merges into a preferably convex end portion ( 4 ) that falls away in the dorsal direction.

The invention concerns a knee prosthesis with a tibial implant that has concave or planar condylar bearing surfaces.

Tibial implants of this type are well known by use. They are sometimes used in conjunction with femoral implants, which have a medial condylar component and a lateral condylar component corresponding to the bearing surfaces of the tibial implant.

The objective of the invention is to create a new knee prosthesis of the aforementioned type that is improved in its functional capabilities, especially with respect to flexions of the knee.

The knee prosthesis of the invention which solves this problem is characterized by the fact that the lateral condylar bearing surface has an end section that slopes away in the dorsal direction.

The advantage of this is that the downwardly sloping end section of the lateral condylar bearing surface allows trouble-free luxation during knee flexion, which is associated with, among other things, a rotation of the femur about an axis perpendicular to the tibial plateau. The lateral femoral condyle or the lateral femoral component of the knee prosthesis can slide off the lateral bearing surface of the tibial implant. In conventional knee prostheses, the tibial and femoral components of the prosthesis come into contact with each other when the knee is bent, which limits the angle of flexion.

The lateral condylar bearing surface can make the transition to the downwardly sloping end section via a convexly curved transition section, and the end section itself is preferably convexly curved.

The end section extends in the dorsal direction, preferably over about one fifth to one third of the length of the lateral condylar bearing surface.

In another embodiment of the invention, the lateral condylar component of a femoral implant of the knee prosthesis has an extension, which comes into contact with the sloping end section during flexion of the knee. Advantageously, this extension forms both a lever and a guide, which facilitate the sliding of the lateral condylar component off the condylar bearing surface.

This extension preferably has a contact surface that is complementary to the end section.

In another embodiment of the invention, the medial condylar bearing surface can be shaped as a depression that widens in the dorsal direction. The advantage of this is that this depression ensures that during flexion of the knee, the contact area between the condylar bearing surface and the medial condyle does not experience an undesired shift in the ventral direction.

In another embodiment of the invention, an elevation with a third bearing surface is formed between the condylar bearing surfaces in the dorsal half of the implant. A projection formed between the condylar components of a femoral implant can be supported on this third bearing surface. Advantageously, this support assists the return rotation of the femur relative to the tibial implant during a flexion of the knee by facilitating the upward movement of the femur implant up the downwardly sloping end section that is necessary during the return movement.

This third bearing surface can be partly formed by a dorsal extension on the tibial implant and preferably ascends towards the free end of the dorsal extension. Corresponding to the rotation of the femoral implant relative to the tibial implant, the third bearing surface preferably runs in a curve that follows the contour of the medial condylar bearing surface.

In another embodiment of the invention, the downwardly sloping end section of the lateral condylar bearing surface makes a transition to another bearing surface that extends perpendicularly to the tibial plateau. An advantage here is that the luxated femur does not lie against the tibia but rather against the implant.

During prolonged knee flexion, e.g., while sitting on the floor with the legs crossed or similar positions, stresses on the tibia are avoided.

The invention is explained in greater detail below with reference to the specific embodiments of the invention that are illustrated in the accompanying drawings.

FIG. 1 is a top view of the plateau of a tibial implant of the invention.

FIG. 2 shows the tibial implant of FIG. 1 along sectional line C-C.

FIG. 3 shows the tibial implant of FIG. 1 along sectional line A-A.

FIG. 4 is a side view of a femoral implant that can be used together with the tibial implant of FIGS. 1 to 3.

FIG. 5 shows the femoral implant of FIG. 4 as viewed in the dorsal direction.

FIGS. 6 and 7 show additional embodiments of a tibial implant of the invention in top views of the implant.

FIG. 8 shows the tibial implant of FIG. 7 as viewed in the ventral direction.

FIG. 9 shows a femoral implant that can be used with the tibial implant of FIGS. 7 and 8 in a knee prosthesis as viewed in the ventral direction.

FIG. 10 is a side view of another embodiment of a tibial implant of the invention as viewed in the ventral direction.

FIG. 11 shows the tibial implant of FIG. 10 along, sectional line B-B.

FIGS. 12 to 14 show further embodiments of tibial implants of the invention.

A tibial implant 1 of a knee prosthesis has a lateral condylar bearing surface 2 and a medial condylar bearing surface 3. The bearing surfaces are basically concave.

As FIG. 3 shows, the lateral condylar bearing surface 2 comprises an end section 4, which, in a top view of the tibial plateau, slopes down to the dorsal edge of the implant. In the embodiment under consideration here, the end section 4 is convexly curved. A transition section 5 between the concave part of the condylar bearing surface 2 and the end section 4 also has concave curvature. A broken line 6 indicates the normal course of the condylar bearing surface 2 without the downwardly sloping end section 4.

During bending of the knee, in which the femur carries out a rotation relative to an axis perpendicular to the tibial plateau, the downwardly sloping end section 4 aids luxation and prevents the femur or femoral implant from striking the dorsal edge of the tibial implant 1.

A femoral implant 7 shown in FIG. 4 can be advantageously used together with the tibial implant 1 described with reference to FIGS. 1 to 3.

The femoral implant 7 has a lateral condylar component 8 and a medial condylar component 9. An extension 10 with a contact surface 11 is connected to the dorsal end of the lateral condylar component 8. The contact surface 11 is designed to be approximately complementary to the end section 4 of the condylar bearing surface 2 of the tibial implant 1.

During a flexion of the knee, the contact surface 11 of the extension 10 contacts the end section 4. On the one hand, this produces leverage, and, on the other hand, the femoral implant 7 is exactly supported on the tibial implant 1 by the extension resting against it. Both facilitate luxation, i.e., the sliding of the condylar component 8 off the condylar bearing surface 2.

In the embodiments described below, parts that are the same or have the same function are designated by the same reference number as in the preceding drawings except that the letter a, b, c, d, e, or f is added to the given reference number.

The tibial plateau of FIG. 6 differs from the tibial plateau of FIG. 1 in that a medial condylar bearing surface 3 a is formed as a depression, whose width increases in the dorsal direction as indicated by the contour line 12. This shaping of the overall concave condylar bearing surface 3 a ensures that the contact area of the medial condyle of the femur or of the medial condylar component of a femoral implant during flexion, in which the femur rotates about an axis perpendicular to the tibial plateau, does not shift in the ventral direction but rather, as viewed in the ventral direction, remains approximately in the first third of the medial condylar bearing surface 3 a.

Besides a condylar bearing surface 3 b, which corresponds to the condylar bearing surface 3 a, the femoral implant 1 b shown in FIG. 7 additionally has a dorsal extension 13. The extension 13 forms part of a third condylar bearing surface 14 that extends between the condylar bearing surfaces 2 b and 3 b. This third bearing surface 14 ascends in the dorsal direction to the free end of the extension 13 and runs in the form of an arc that follows approximately a contour 15 of the medial condylar bearing surface 3 b.

The tibial implant shown in FIGS. 7 and 8 can be used in a knee prosthesis together with the femoral implant 7 b shown in FIG. 9.

In addition to a lateral condylar component 8 b and a medial condylar component 9 b, the femoral implant 7 b has a projection 16 between the condylar components.

If, during an extension of the flexed knee, the femur is to move back into the rotational position corresponding to the unflexed knee, the return rotation of the femur associated with this requires that the lateral condyle 8 b slide up the end section 4 b to the concave part of the condylar bearing surface 2 b.

This necessitates lifting of the femur, which is accomplished by virtue of the fact that during the extension, the projection 16 comes into contact with the third bearing surface 14, which has a curvature in accordance with the necessary rotation of the femur.

In the tibial implant 1 c shown in FIGS. 10 and 11, a downwardly sloping section 4 c of a lateral condylar bearing surface 2 c makes a transition to another bearing surface 17, which extends basically perpendicularly to the tibial plateau. The other bearing surface 17 is formed by an extension 18 that projects in the direction of the tibia. In the illustrated embodiment, the projecting length of the extension 18 decreases linearly towards the ventral edge of the tibial plateau 1 c. A milled-out recess for receiving an insert of this type can be produced during the implantation with comparatively little effort. Alternatively, the additional bearing surface could also be formed by a projecting tongue, as is indicated in FIG. 11 by a broken line.

During the luxation, the femur makes contact with the additional bearing surface 17. Especially during prolonged flexions, such as occur while sitting on the floor, the implant protects the tibia from long-term stress by the luxated femur.

FIG. 12 shows additional forms of tibial implants with different condylar bearing surfaces 2 d, 2 d′, and 2 d″. The condylar bearing surface 2 d″ is shaped convexly in the form of a circular arc.

FIG. 13 shows a top view of a tibial implant with condylar bearing surfaces 2 e and 3 e. The implant has a recess through which cruciate ligaments 22 and 23 can pass.

FIG. 14 shows additional tibial implants with condylar bearing surfaces 2 f and extensions 18 f. The extensions 18 f have various additional bearing surfaces 17 f, 17 f″, 17 f″′, and 17 f″″. 

1. A knee prosthesis with a tibial implant (1) that has concave or planar condylar bearing surfaces (2, 3), wherein the lateral condylar bearing surface (2) has an end section (4) that slopes away in the dorsal direction.
 2. Knee prosthesis in accordance with claim 1, wherein the lateral condylar bearing surface (2) makes the transition to the downwardly sloping end section (4) via a convexly curved transition section (5).
 3. A knee prosthesis in accordance with claim 1, wherein the end section (4) extends in the dorsal direction over about one fifth to one third of the length of the lateral condylar bearing surface (2).
 4. A knee prosthesis in accordance with claim 1, wherein the end section (4) is convexly curved.
 5. A knee prosthesis in accordance with claim 1, wherein the lateral condylar component of a femoral implant (7) of the knee prosthesis has an extension (10), which comes into contact with the end section (4) during flexion of the knee.
 6. A knee prosthesis in accordance with claim 5, wherein the extension (10) has a contact surface (11) that is complementary to the end section (4).
 7. A knee prosthesis in accordance with claim 1, wherein the medial condylar bearing surface (3 a; 3 b) has a depression (12) that widens in the dorsal direction.
 8. A knee prosthesis in accordance with claim 1, wherein an elevation with a third bearing surface (14) is formed between the condylar bearing surfaces (2 b, 3 b) in the dorsal half of the implant and that a projection (16) formed between the condylar components (8 b, 9 b) of a femoral implant (7 b) can be supported on this third bearing surface (14).
 9. A knee prosthesis in accordance with claim 8, wherein the third bearing surface (14) is partly formed by a dorsal extension (13) on the tibial implant (1 b).
 10. A knee prosthesis in accordance with claim 9, wherein the third bearing surface (14) ascends towards the free end of the dorsal extension (13).
 11. A knee prosthesis in accordance with claim 9, wherein the third bearing surface (14) runs in a curve that approximately follows the contour (15) of the medial condylar bearing surface (3 b).
 12. A knee prosthesis in accordance with claim 1, wherein the downwardly sloping end section (4 c) of the lateral condylar bearing surface (2 c) makes a transition to a dorsal bearing surface (17) that extends perpendicularly or on average perpendicularly to the tibial plateau.
 13. A knee prosthesis in accordance with claim 12, wherein the additional bearing surface (17) is formed by an extension (18), which projects from the side of the tibial implant (1 c) that faces away from the bearing surfaces (2 c, 3 c).
 14. A knee prosthesis in accordance with claim 13, wherein the projecting length of the extension (18) decreases, preferably linearly, towards the ventral side of the tibial plateau (1 c). 